Table 2 Summary of eight cost-effectiveness studies
From: Systematic review of cost and cost-effectiveness of different TB-screening strategies
Study period | Country | Study population | Outcome | Strategies | Results | |
|---|---|---|---|---|---|---|
Pooran et al. [21] | 2 years | UK | Close contacts | Incremental costs/active TB case prevented | TST-only T-SPOT.TB-only TST+T-SPOT QFT-only TST+QFT | ₤ 47,840 ₤ 39,712 ₤ 37,206 ₤ 42,051 ₤ 37,699 |
Marra et al. [22] | 20 years, 3% discounted | Canada | Close contacts of foreign-born, non-aboriginal Canadian-born and aboriginal TB cases | Incremental costs/QALY | QFT (BCG+) + TST (BCG-) TST+QFT (BCG+) +TST (BCG-) QFT (foreign-born, aboriginal, BCG+) +TST (BCG-) QFT (foreign-born and aboriginal) + TST (others) TST+QFT (foreign-born, aboriginal, BCG+) +TST (others) TST+QFT (foreign-born, ab-original) + TST (others) TST+QFT (all) QFT (all) | Dominant Dominant CAD 31,930 CAD 40,433 CAD 135,672 Dominated Dominated CAD 79,443 |
Oxlade et al. [23] | 20 years, 3% discounted | Canada | Close and casual contacts | Incremental costs/case prevented | No screening TST QFT TST+QFT | TST cost saving in close contacts (and casual contacts from low incidence countries) with exception of contacts receiving BCG after infancy (cost savings for QFT) |
Immigrants | Incremental costs/case prevented | No screening CXR only TST only QFT only TST+QFT | least expensive for subjects from high and intermediate incidence countries: CAD 875-30,680 Less expensive than QFT: CAD 46,600 (high incidence) -800,000 (intermediate) Most expensive: CAD 62, 643 (high incidence) 75, 777 (intermediate) Least expensive for subjects from low inci-dence countries): CAD 27,369-45,827 | |||
Kowada et al.[24] | Lifetime, 3% discounted | Japan | Close contacts | Incremental costs/QALY | IGRA-only TST-only TST+IGRA | $ 471.54 $ 573.98, dominated by IGRA-only $ 500.55, dominated by IGRA-only |
de Perio et al. [25] | Lifetime, 3% discounted | USA | HCWs with no BCG vaccination | Incremental costs/QALY | QFT-IT QFT-G TST | Not assessed $ 14,092 Dominated |
HCWs with BCG vaccination | QFT-IT QFT-G TST | Not assessed $ 103,047 Dominated | ||||
Deuffic-Burban et al. [26] | Lifetime, 3% discounted | France | Close contacts | Incremental costs/LYG | No screening TST ≥ 10 mm +QFT QFT TST ≥ 5 mm | € 560 € 730 Strongly dominated |
TST ≥ 5 mm +QFT TST ≥ 10 mm | Weakly dominated Strongly dominated | |||||
Diel et al. 2007 [27] | 20 years 3% discounted | Germany | Close contacts | Incremental costs/LYG | No treatment TST > 5 TST > 10 QFT TST+QFT | $ 30,170 dominant dominant dominant |
Diel et al. [28] | 20 years, 3% discounted | Switzerland | Close contacts in middle-aged group | Incremental costs/LYG | TST > 5 mm TST > 10 mm TST > 15 mm T-SPOT-only TST+T-SPOT | € 141,502 € 107,151 € 44,831 € 23,692 € 23,692 |
Young group | Incremental costs/LYG | TST > 5 mm TST > 10 mm TST > 15 mm T-SPOT-only TST+T-SPOT | € 96,705 € 70,955 € 26,451 € 11,621 € 11,621 |